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Triage for out-of-hours primary care calls: a reliability study of a new French-language algorithm, the SALOMON rule

Introduction: Triage systems for out-of-hours primary care physician (PCP) calls have been implemented empirically but no triage algorithm has been validated to date. A triage algorithm named SALOMON (Système Algorithmique Liégeois d’Orientation pour la Médecine Omnipraticienne Nocturne) was develop...

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Autores principales: Brasseur, Edmond, Servotte, Jean-Christophe, Donneau, Anne-Francoise, Stipulante, Samuel, d'Orio, Vincent, Ghuysen, Alexandre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567030/
https://www.ncbi.nlm.nih.gov/pubmed/31033368
http://dx.doi.org/10.1080/02813432.2019.1608057
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author Brasseur, Edmond
Servotte, Jean-Christophe
Donneau, Anne-Francoise
Stipulante, Samuel
d'Orio, Vincent
Ghuysen, Alexandre
author_facet Brasseur, Edmond
Servotte, Jean-Christophe
Donneau, Anne-Francoise
Stipulante, Samuel
d'Orio, Vincent
Ghuysen, Alexandre
author_sort Brasseur, Edmond
collection PubMed
description Introduction: Triage systems for out-of-hours primary care physician (PCP) calls have been implemented empirically but no triage algorithm has been validated to date. A triage algorithm named SALOMON (Système Algorithmique Liégeois d’Orientation pour la Médecine Omnipraticienne Nocturne) was developed to guide triage nurses. This study assessed the performance of the algorithm using simulated PCP calls. Methods: Ten nurses were involved in 130 simulated PCP call scenarios, allowing the determination of SALOMON’s inter-rater agreement by comparing the actual choices of a specific triage flowchart and the level of care selected as compared with reference assignments. Intra-rater agreement was estimated by comparing triage after training (T1) and 3 to 6 months after SALOMON use in clinical practice (T2). Results: Overall selection of flowcharts was accurate for 94 .1% of scenarios at T1 and 98.7% at T2. Level of triage was adequate for 93.4% of scenarios at T1 and 98.5% at T2. Both flowchart and triage level accuracy improved significantly from T1 to T2 (p < 0.0001). SALOMON algorithm use is associated with a 0.97/0.99 sensitivity and 0.97/0.99 specificity, at T1/T2 respectively. Conclusions: Results revealed that using the SALOMON algorithm is valid for out-of-hours PCP calls triage by nurses. The criterion validity of this algorithm should be further evaluated through its implementation in a real life setting.
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spelling pubmed-65670302019-06-21 Triage for out-of-hours primary care calls: a reliability study of a new French-language algorithm, the SALOMON rule Brasseur, Edmond Servotte, Jean-Christophe Donneau, Anne-Francoise Stipulante, Samuel d'Orio, Vincent Ghuysen, Alexandre Scand J Prim Health Care Research Article Introduction: Triage systems for out-of-hours primary care physician (PCP) calls have been implemented empirically but no triage algorithm has been validated to date. A triage algorithm named SALOMON (Système Algorithmique Liégeois d’Orientation pour la Médecine Omnipraticienne Nocturne) was developed to guide triage nurses. This study assessed the performance of the algorithm using simulated PCP calls. Methods: Ten nurses were involved in 130 simulated PCP call scenarios, allowing the determination of SALOMON’s inter-rater agreement by comparing the actual choices of a specific triage flowchart and the level of care selected as compared with reference assignments. Intra-rater agreement was estimated by comparing triage after training (T1) and 3 to 6 months after SALOMON use in clinical practice (T2). Results: Overall selection of flowcharts was accurate for 94 .1% of scenarios at T1 and 98.7% at T2. Level of triage was adequate for 93.4% of scenarios at T1 and 98.5% at T2. Both flowchart and triage level accuracy improved significantly from T1 to T2 (p < 0.0001). SALOMON algorithm use is associated with a 0.97/0.99 sensitivity and 0.97/0.99 specificity, at T1/T2 respectively. Conclusions: Results revealed that using the SALOMON algorithm is valid for out-of-hours PCP calls triage by nurses. The criterion validity of this algorithm should be further evaluated through its implementation in a real life setting. Taylor & Francis 2019-04-29 /pmc/articles/PMC6567030/ /pubmed/31033368 http://dx.doi.org/10.1080/02813432.2019.1608057 Text en © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Brasseur, Edmond
Servotte, Jean-Christophe
Donneau, Anne-Francoise
Stipulante, Samuel
d'Orio, Vincent
Ghuysen, Alexandre
Triage for out-of-hours primary care calls: a reliability study of a new French-language algorithm, the SALOMON rule
title Triage for out-of-hours primary care calls: a reliability study of a new French-language algorithm, the SALOMON rule
title_full Triage for out-of-hours primary care calls: a reliability study of a new French-language algorithm, the SALOMON rule
title_fullStr Triage for out-of-hours primary care calls: a reliability study of a new French-language algorithm, the SALOMON rule
title_full_unstemmed Triage for out-of-hours primary care calls: a reliability study of a new French-language algorithm, the SALOMON rule
title_short Triage for out-of-hours primary care calls: a reliability study of a new French-language algorithm, the SALOMON rule
title_sort triage for out-of-hours primary care calls: a reliability study of a new french-language algorithm, the salomon rule
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567030/
https://www.ncbi.nlm.nih.gov/pubmed/31033368
http://dx.doi.org/10.1080/02813432.2019.1608057
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